Case 33-2003 - A 37-Year-Old Man with a History of Alcohol and Drug Abuse and Sudden Onset of Leg Weakness

doi:10.1056/NEJMcpc030008

Volume 349:1656-1663		October 23, 2003		Number 17

Case 33-2003 — A 37-Year-Old Man with a History of Alcohol and Drug Abuse and Sudden Onset of Leg Weakness

Oscar Soto, M.D., and E. Tessa Hedley-Whyte, M.D.

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Presentation of Case

A 37-year-old man was admitted to the hospital because of collapse.

The patient was unmarried and unemployed and was a former smoker.He had abused alcohol since the age of 13 years and had beenadmitted for detoxification on numerous occasions because ofalcohol abuse and use of illicit drugs. Since his early teens,he had had an eating disorder that led to obesity. During the10 years before admission, he had asthma, proteinuria, and hypertension.Six years before admission, he began to use intermittent dosesof colchicine and indomethacin for gouty arthritis.

Three years before admission, a gastric bypass . . . [Full Text of this Article]

Differential Diagnosis

Upper-Motor-Neuron Dysfunction

Myopathies

Alcoholic Myopathy

Colchicine Myoneuropathy

Clinical Diagnosis

Dr. Oscar Soto's Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Departamento de Neurologia, Clinica Universitaria de Navarra, Pamplona, Navarra, Spain (O.S.); and the Department of Pathology, Massachusetts General Hospital and Harvard Medical School (E.T.H.-W.).